"These are really important benefits, but they occur in a small number of men". Now it favors letting men decide for themselves after talking with their doctor. But the results of a new survey, published in the journal JAMA Internal Medicine, suggests that most doctors are not heeding that advice.
New proposed guidelines by the U.S. Preventive Task Force suggests men should discuss PSA blood tests with doctors on an individual basis. All treatments have side effects, from sexual function to urinary function, bowel function, and more.
An influential federal task force is relaxing its controversial opposition to routine screening for prostate cancer. Some cancers, ironically the ones easiest to diagnose and cure, are so slow-growing they are of no threat to the patient: They do not need to be cured, as they would never do harm if left alone. Doctors say there's no good way to tell which early cancers might become lethal.
The shift shelves the panel's 2012 guidance, which prompted criticism from some urologists specialists who treat the disease and angered some prostate cancer patients certain that PSA screening had saved their lives. Now, the panel says discussion between a man and his doctor should guide decisions around getting the test.
The task force's recommendations influence US government policy and are widely followed by primary care physicians.
Let's say 1,000 men get a blood test for prostate cancer, which runs about $40 and measures the prostate-specific antigen (PSA), a protein made by the prostate gland. There is a big difference between the phrase "reduces the risk of dying from prostate cancer" and the phrase "reduces the risk of dying".
The new guidelines are relatively simple: Men between the ages of 55 to 69 should start a conversation with their doctors about whether to have a PSA test and focus on their own values and priorities.
Hungarians Plan More Protests as President's Deadline Nears
Other chants included "A free country, a free university", "Orban get out", "Viktator!" and "Europe, Europe". The CEU operates in Budapest but is the only worldwide college with no branch outside Hungary .
For men age 70 and older, the group continues to conclude that any benefits of screening 'do not outweigh the harms'. "This is not a recommendation that says men should go get screened".
"Prostate screening has been a contentious issue ever since the prostate specific antigen test became available more than three decades ago", Dr. Otis Brawley, chief medical officer of the American Cancer Society, wrote today in a CNN op-ed. It is a highly respected, highly skilled group of public health experts who review scientific studies and make recommendations on disease prevention and screening. The upgrading from the "D" rating in 2012 is based partly on recent scientific evidence that increased the USPSTF's certainty about reduced chances of PCa metastases and deaths. It cautions that "many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and impotence".
Taylor was diagnosed with Stage IV cancer and was put on an aggressive treatment regimen at the MD Anderson Cancer Center in Houston that has included surgery, chemotherapy and immunotherapy.
The new USPSTF guideline gives PSA testing a grade of C, which essentially means that there are risks and benefits and a doctor should have a discussion with a patient to help reach a decision regarding whether or not the PSA should be checked. Dr. Meir Stampfer, a Harvard University cancer expert, called the new advice "a more reasoned approach".
Prostate cancer mortality dropped almost 40 percent over the last decade, which many medical professionals attribute largely to early detection with the PSA blood test.
Most men with a high PSA will undergo a biopsy to determine whether there is cancer. The PSA test only has a small percent chance of detecting cancer, but often times the procedure causes several unwanted side effects. Their recommendations influence USA government policy, primary care physicians and private insurers' coverage decisions.
While these benefits may take 10 years or more to see, the harms from screening and treatment are immediate, she noted. Prostate cancer is the third most common cause of cancer death among American men, behind lung cancer and colorectal cancer; it is clearly a disease where effective screening and treatment is needed.